AKI Flashcards
criteria for diagnosing AKI
rise in creatinine of >26.5micromol/L in 48hr
rise in creatinine of >= 1.5 times baseline in 7 days
urine output <0.5ml/kg/hr for 6 hrs
intrarenal causes of AKI
glomerulonephritis
vasculitis
radiocontrast
lupus
myeloma
drugs
rhabdomyolysis
interstitial nephritis
acute tubular necrosis
prerenal causes of AKI
Dehydration
Hypotension (shock)
Heart failure
sepsis
vomiting and diarrhoea
postrenal causes of AKI
Kidney stones
Masses such as cancer in the abdomen or pelvis
Ureter or uretral strictures
Enlarged prostate or prostate cancer
investigations
urinalysis- leucocytes and nitrites, protein and blood, glucose
US if obstruction
management
IV fluids
optimise BP and volume status
sick day rules
stop NSAIDs, ARBs, ACEis, Diuretics, metformin
relieve obstruction
daily U+Es
dialysis if severe
complications
metabolic acidosis
uraemia
fluid overload
hyperkalaemia
RFs
Chronic kidney disease
Heart failure
Diabetes
Liver disease
Older age (above 65 years)
Cognitive impairment
Nephrotoxic medications such as NSAIDS and ACE inhibitors
Use of a contrast medium such as during CT scans
indications for dialysis in AKI
A acidosis
E electrolyte imbalance
I intoxication
O overload
U uraemic complications